Health agency chiefs defend Trump's plan to lower drug prices

Health agency chiefs defend Trump's plan to lower drug prices

President Donald Trump's long-promised plan to bring down drug prices would mostly spare the pharmaceutical industry he previously accused of "getting away with murder".

Health and Human Services Secretary Alex Azar has this pen. Trump had attacked prescription drug companies for high drug prices during his election campaign. And he doesn't need congressional approval to do it.

Instead, citing a "tangled web of special interests" as the premise, it only offers to fix the process at the level of the manufacturer, insurer, and pharmacy benefit manager, with wishful thinking that telling foreign governments to pay more for drugs would somehow result in lower prices in the U.S. Putting "American Patients First"? "It took decades to erect this very complex, interwoven system", Azar said in a briefing following the speech. Extra innovation is welcome but, unless America gets a grip on prices at the same time, it will lead to yet more costly new drugs offering poor clinical value. Azar said there is no way to ensure such drugs are really from Canada or Europe, rather than routed from a counterfeit factory elsewhere.

Azar, a former pharmaceutical company executive, said Trump views tougher negotiation as key to the plan.

David Mitchell, founder of the advocacy group Patients for Affordable Drugs, approves of the idea. "Where exactly do we think those price reductions come from?"

But Express Scripts spokesman Brian Henry takes issue with targeting PBMs. "The root cause is the pharmaceutical companies who set these prices", he said.

- Reconsidering how Medicare pays for some high-priced drugs administered at doctors' offices.

In his remarks, Azar outlined a presidential directive to "bring negotiation where it doesn't exist", merging Part B, Medicare's program for physician-administered drugs, with Part D. The Part D program was implemented in 2006-when Azar was deputy health secretary and before he departed to become president of Eli Lilly's USA subsidiary.

Azar said he wants to move some of the most expensive of those drugs to the Part D program, which is administered by private health insurance companies that negotiate discounts with drug companies.

"These are sophisticated drugs for complicated diseases", Antos said. "Some Part B drugs - many of which are infusions like chemotherapy - don't have competitors, so negotiation may not help much".

The Centers for Medicare and Medicaid Services will release new versions of its Medicare and Medicaid drug price dashboards on Tuesday that HHS says will have more detail on how much the programs are paying for the medications they buy.

Trump's speech singled out foreign governments that "extort unreasonably low prices from US drugmakers" using price controls and said USA trade representatives would prioritize the issue in trade deals.

In the U.S., Medicare is the largest purchaser of prescription drugs, covering 60 million seniors and Americans with disabilities, but it is barred by law from directly negotiating lower prices with drugmakers.

"It's hard to know why Germany or France or Australia would agree to something like that", said Professor Jack Hoadley of Georgetown University's Health Policy Institute. "That said, they sure are talking a good game and should be given deference that action will approach rhetoric".

Pharmaceutical investors and analysts expressed relief after the announcement, and shares of most top drugmakers rose Friday afternoon, including Pfizer, Johnson & Johnson and Eli Lilly. At the moment it can not haggle directly with drug companies.

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